Generally speaking, bony work will have
a far more dramatic effect on face shape, which is necessary in some cases in
order to be accepted as female. Men and women have basic differences in skull
shapes, and if you have a skull shape outside of female range, it might make
being accepted as female more difficult.

Soft tissue work can be enough for some
women to be accepted as female. Soft tissue work may be necessary to get the
full result of bony work for some women. In general soft tissue work will smooth
and tighten areas, making you look younger and by extension more feminine. There
are masculine and feminine aging patterns, and getting rid of certain soft tissue
traits can make a significant difference in your ability to be accepted as female.